PAPER TYPE: “_” Sindh Public Service Commission, Hyderabad Pre-Interview Written Test for the post of Medical Officer/Medical Officer(Minorities)/Medical Officer(Disable/Medico Legal Officer/Caualty Medical ficer(Male) BPS-17 under Health Department, Government of Sindh. ‘Tuesday the 26" April, 2016 Maxirmura marks: 100 ‘Time: 03:00 pm to 4:40 pm "QUESTION PAPER General Instruction OL Candidates are to attempt all questions. 02 Write your Roll No, Name, Father's/Husband's Name & Centre on the Answer Sheet within the space provided. 03. _Donot write these data anywhere else on the answer sheet. Doing so will render the candidate disqualified (04 Follow instructions on the Answer sheet to mark your response correctly. Answer carefully by filling one of the appropriate blank cells provided in the Answers Sheet with Black or Blue ball pen only. 0S Sign your answer sheet in space provided above. 06 Return both your Question paper and Answer sheet after the exams. ‘Most Important: Any Candidate found in possession of mobile phone or anv similar device in the ‘examination hall will_be expelled from the Examination Hall . Question paper is part of answer sheet for assessment purpose. No candidate is allowed to carry question paper / answer sheet out of the ‘examination hall, ‘01 | Urinary bladder and urethra are drived from the : (A) primitive-urogenital sinus (B) Metanephrons (C) Para-mesonephries duct (D) Mesonephric duct 02 | Influenza pandemic occurs after every 7 ~ 10 years. This kind of disease distribution in time is known as: (A) Secular trend _(B) Short time fluctuation __(C) Cyclical trend _(D) Seasonal trend. {05 | Blood stained foul smell Nasal discharge is usually seen in patients having: (A) DNS (B) Nasal Polyp (C) Rhinolith (D) Angiofibroma (B) Inverted Papiloma 04 | In which condition X-Ray neck lateral view shows the thumb sign: (A) Acute Laryngitis (B) Acute Pharyngitis (C) Acute Epiglotitis (D) Acute Tonsilli (E) Acute Tracheobronchitis - 05 | Regarding principles of arthropods control, the elimination of breeding places of the insects is: (A) Environmental control (B) Genetie control (C) Biological control (D) Physical control | (E) Chemical control - - | 06 | Which of the following is the disease most commonly seen in rural environment: (A) Farmer's lung _(B) Tuberculosis _(C) Bronchitis _(D) HIV/AIDS _(E) Meningitis 07 | Which is the appropriate clinical finding for diagnosis of uterine rupture during antenatal period | | (A) Abdominal pain and tenderness (B) Shock | (©) Vaginal bleeding profuse with passage of clots (D) Fetal tachycardia/Bradycardia () High and obvious fetal presenting parts on abdominal examination 08 | In Charcot neuro arthropathy: (A) It is non-infective arthropathy with poor perfusion (B) It is caused by.minor trauma in presence of in sensitivity & sympathetic dysfunction | (C) Blood flow is good (D) Foot become cold to touch (E) Patient can walk with discomfort. 09 | Diagnosis of glandular fever is confirmed by: (A) Positive monospot test (B) Raised liver enzyme (C) Leucoeytosis (D) C-reactive protein (©) Hb AIC 10 | Which of the following is not a branch of the ophthalmie nerve: | (A) Supraorbital (B) Supratrochlear (C) Infraorbital (D) External nasal TT | Which of the following is true regarding RU 4867 is (A) Prevents fertilization (B) Has affinity for estrogen receptors (C) Single dose of 10mg prevents pregnancy in 90% cases (D) Causes delayed menstruation (E) Reduce bleeding kL DL of 06 :Which of the following infections agent may lead to development of liver cancer? (A) Hepatitis B virus (B) Human Immuno deficiency virus (HIV) (C) Adenovirus (D) Polio virus (E) Entero virus Inability to perform alternating movement of the hands is referred to as: (A) Dysdiadochokinesia (B) Dyskinesia (C) Romberg’s sign (D) Chorea (E) Athetosis. ‘Which of the following is Antifungal agent: (A)Gentamycin __(B)Tobramycin__(C) Canestin_(D) Penecillin _(B) Asprin | ‘The common urinary symptoms with anterior vaginal wall prolapsed include: (A) Urinary retention (B) Recurrent urinary tract infection (C) Haematuria (D) True incontinence of urine (E) Detrusor over activity | ‘Bitemporal hemianopia is present in: (A) Craniopharygioma (B) Pituitary tumor (C) Meningioma (D) Astrocytoma (E) Schwanoma, Regarding esophageal atresia, which of the following statements is not true about esophageal atresia? (A) It leads to excessive salivation and / or choking spells when 1* feed is attempted (B) Its associated with VACTER anomalies (C) X ray shows abscent gas in the abdomen (D) Primary surgical repair is preferred 7 The thyroid develops from? a (A) Ectoderm (B) Mesoderm (C) Dorsal pharyngeal gut endoderm (D) Ventral pharyngeal gut endoderm 20 Reed-stenberg cells are characteristic of: (A) Hodgkin’s lymphoma (B) Non-Hodgkin’s lymphoma (C) Burkitt's lymphoma (D) B-cell lymphoma (E) T-cell lymphoma | Following pelvic surgery, a patient reports numbness along the medial thigh as well as weakness | of hip adduction, Which nerve has most likely been injured during the operation (A) Obturator (B) Femoral (C) Inferior gluteal (D) Superior gluteal (E) Sciatic 21 Regarding the use of ocular staining dyes: (A) Fluorescein is used to stain comeal cpithelium (B) Rose Bengal is used to stain vitalized corneal tissue (C) Fluorescein dye is used to stain de-vitalized tissue (D) Merbromin dye is used to stain endothelium of blood vessels (E) Rose Bengal is used to stain margins of comeal epithelium 2 Which of the following is Ototoxic drug: (A) Gentamycin (B) Contimycin (C) Amoxicillin (D) Erythrocin (E) Penecillin 23 Plummer Vinson syndrome is characterized by all except: (A) Clubbing (B) Dysphagia (C) Angular Stomatitis (D) Anaemia (E) Pale conjunctiva 24 Characteristics features of Acute intermittent Porphyria include: (A) Exesssive faecal protoporphyrin excretion (B) Excessive urinary porphobilinogen excretion between acute attacks (C) Hypematraemia during attacks (D) Photosensitivity (E) Autosomal recessive inheritance 25 ‘Optical condition in aphakia is: (A) Hypermatropia (B) Myopia (C) Astigmatism with rule (D) Presbyopia (E) Astigmatism against rule 26 27 The serum B HCG level in ectopic pregnancy: (A) Increases at a normal rate in 7-10% of cases (B) Doubles abruptly till 5 weeks duration (C) Rises slowly and then levels doubles in 30 hours (D) Level reach peak at 7 weeks gestation (E) Is primary investigation then the ultrasound examination ‘Malignant tumors of the larynx spreads via: (A) Lymphatic channel (B) Nerve (C) Blood (D) Direct spread to distant structures (E) All of these 28 ‘All are lipid storage diseases, except: (A) Gaucher's disease (B) Niemann’s disease (©)Sach’s disease __(D) Berie berie disease 29 Regarding Acute Maxillary Sinusitis, all are correct, except: (A) Is the sequel to common cold (B) Precipitated by swimming and diving in unhygienie water (C) Streptococcal organism is its causative agent (D) Cheek pain radiating to upper jaw (E) Antral wash out is its surgical treatment 02 of 06 -“30 In the Diabetic Toot (A) They are more common in men aged 40 years (B) Hand lesion is not a presenting feature of type-2 diabetes (O Its least common cause of hospital admission of Diabetic patients (D) 30% of foot amputation if preventable if patient are educated about foot care ©) Itis more common in Asian and socially affluent Diabetic 31 Poloyeythaemia rubra vera : (A) Is usually associated with a moderately elevated ESR (B) Usually terminated as an acute myeloid leukaemia (C) Is associated with thrombocythaemia (D) Is associated with low leukocyte alkaline phosphates activity | (E) Is not associated with a prolonged bleeding time is most cases [32 Regarding the lateral mesoderm is divided into two distinct layers by the formation of: (A) Extra-embryonie coelom (B) Intra-embryonic coclom —_(C) Cardiogenic region | (D) Notochord B Renal adenocarcinomas: (A) Are of transitional cell origin _(B) Usually are associated with anemia (C) Are difficult to diagnose (D) Are extremely radiosensitive (E) Frequently are signaled by gross hematuria, (34 Primary hemorrhage in Tonsillectomy ean occur in all, except: (A) Infection (B) Rough dissection (C) Fibrosed Tonsils (D) Post operative persistent cough (E) Rise of blood pressure 35 Fach one of the following is a recognized feature of anorexia nervosa except: (A) Hypokalemia (B)LowLH —(C) Impaired glucose tolerance (D) Low FSH (E) Reduced growth hormone Level 36 Increased number of Eosinophils in Nasal smear is seen in (A) Atrophic Rhinitis (B) Rhinitis Medica Mentosa (C) Allergic Rhinitis (D) Vasomotor Rhinitis (E) Rhinitis Sicca 7 ‘Anaemic heart disease is a complication of (A) Hook worm _(B) Whip worm __(C) Thread worm (D) Round worm (E) Flariases | 38 Which one of the following is a risk factor for preeclampsia: (A) BMIk25 (B) Diabetes (C) Intrepregnancy interval of >8 years (D) Antiphospholipid antibodies (E) Multiparity 39 ‘Additional procedures in the management of diabetic ketoacidosis does not include: (A) Nasogastric tube to keep stomach empty in unconscious patients (B) Antibiotic if infection is suspected (C) ECG monitoring in severe cases (D) Plasma expander if systolic BP<90 mm of Hg | (E) Plasma expander iff systolic BP< 90 mm of Hg if does not rise with /V saline cy “Malabsorption due to a mucosal intestinal defect occurs in: (A) Chronic pancreatitis (B) Celiac disease (C) Ulcerative colitis (D) Cystic Fibrosis a Kluver-Bucy syndrome is due to lesion of which of the following: (A) Cerebellum (B) Amygdala (C) Fornix (D) Hypothalamus (E) Thalamus a2 8 It is true regarding facial nerve paralysis, except: (A) Also seen in Herpes-Zoster (B) Bel!’s paralysis (C) ttean be detected on C.T. scan __(D) Supra-nuclear damage | "A 52 year old postmenopausal woman presents in OPD with the complaint of lower abdominal | pain, Her ultra sound shows left sided ovarian cyster of Sem, her CA-125 is 15Mg. The most appropriate option for the treatment of this case is: (A) Urs guided aspiration of cyst (B) Administration of IV antibiotics (C) Cystectomy (D) Laprotomy, TAH & BSO (E) Follow up observation Following familial cancer syndromes exhiloit autosomal recessive inheritance except: (A) Ataxia telangiectasia (B) Bloom's syndrome (C) Wilson's tumor (D) Fanconi’s anaemia (E) Xeroderma pigmentosa - 5 “Aphakia is defined as: (A) Presence of lens in its normal position (B) Absence of lens from its normal position (C) Subluxation of lens (D) Upward deviation (E) Change in colour of lens %6 ‘Which of the following is the most common cause of neonatal deaths in developing countries? | (A) Neonatal sepsis (B) Amoebiasis (C) Neonatal tetanus (D) Meningitis (E) Birth asphyxia | | 03 of 06a Treatment of Nasopharyngeal Angiofibroma is: (A) Radiotherapy (B) Chemotherapy (C) Surgery (D) Harmonal therapy (E) VV Antibiotics 48 Which of the following is imidazole derivative: (A) Thiopentone sodium __(B) Methohexitone_(C) Propofol_(D) Etomidate 49 Tn the alveolar region of the lungs: to diffusion of gases is about 10 u.m thick (B) Srfactant-secreting cells form a continuous cytoplasmic layer lining the alveoli (©) Alveoli are larger in the upper and smaller in the lower zones of the lungs (D) If any fluid escapes from capillaries, it goes into the alveoli (E) Macrophages in the alveoli are carried to the respiratory bronchioles by the activity of cilie. 30 Which one of the following occurs in long standing case of Chronic Suppurative Otitis Media: (A) Acoustic Neuroma (B) Glomus Tumor (C) Persistent T.M Perforation (D) Basal Cell Carcinoma (E) Mienier’s Disease 31 Functional residual capacity is: (A) The volume of air inhaled during inspiration (B) The volume of air exhaled during exhalation (C) The maximal amount of air the can be exhaled after quiet expiration (D) The amount of air left in the lungs at the end of normal, resting expiration (E) The volume of air expired forcefully after maximar inspiration In pathogensis of ulcerative colitis (UC): (A) Appendectomy has protective effect (B) Cigarette smoking has not detrimental effect (C) The mucosal é-cell & plasma cell increase in UC (D) The patient may improve with broad spectrum antibiotics (E) Environmental factor are more important than gentic factors in UC 33 “The junction of cornea and sclera is known as: (A) Angle of anterior chamber (B) Trabecular mesh work (C) Limbus (D) Collaret line (B) Sulcus a | Levator palpebrae superioris muscle is supplied by: (A) 3" nerve (B) 4" nerve (C) 5" nerve (D) 6" nerve (E) 7" nerve 55 | Regarding causes of acute sore throat includes all, except: (A) Acute tonslitis (B) Pharyngeal diphtheria (C) Acute Pharyngitis (D) Quinsy. 36 | Common site for tracheostomy is + 7 (A) 1* and 2" Tracheal Rings (B) 3" and 4" Tracheal Rings (C) 5" and 6° Tracheal Rings | (D) Just above the 1" Tracheal Ring (E) Just below the Cricoid Cartilage Which of the following is an iceberg disease? (A) Acute gastroenteritis (B) Malaria (C) Dengue fever (D) Hypertension (E) Plague 38 Regarding medico-legal certificate, which of the following statement is appropriate: (A) Iris document relevant to the cause of death (B) Itis certificate describing the manner of death (C) Itis certificate of working ability/capability (D) tis certificate of injuries sustained by person - 39 Tn case of hoarseness of voice, the site of lesion is: (A) Base of Tongue (B) Vallecula (C) Vocal Cord (D) Pyriform fossa (E) Ary-epiglottic folds 60 Regarding folic acid deficiency megaloblastic anemia, this occurs in: (A) Strick vegetarians (B) Gluten enteropathy (C) Hypertension (D) Diuretic therapy (E) Pin worm infection G1] When number of calculated females is expressed as a % of total females present in village. It is | called: (A) Frequency _(B) Ratio _(C) Rate_(D) Proportion $2 | The best period of gestation to carry out chorion villous biopsy for prenatal diagnosis is? eB (A) 8-10 weeks __(B) 10 ~ 12. weeks (C) 12-14 weeks (D) 14 -16 weeks Manual vacuum aspiration can be performed without regional anesthesia up to: (A) 5-6 weeks _ (B) 6-7 weeks (C) 7-15 weeks (D) 15-20 weeks (E) 20-24 weeks 64 ‘At the beginning of the forced expiration : (A) Lung elastic recoil increases (B) Airway resistance decreases (C) Intrathoracic airways widen (D) Transmural airway pressure remains low (E) 02 pressure increases in airways 04 of 06 |6 ] In acute tubular necrosis: (A) The urinary sodium concentration is classically less than 30 mmol/l (B) The urine plasma osomolality ratio is more than 1:2 | (C) Red cell casts are usually present in the urine (D) Proteinuria is a expected findings | (E) The creatinine clearance is within the normal range, 1 year after the disease onset, in almost | all patients 66 Which of the following statements is true for polio vaccines: (A) Salk is an inactivated polio vaccine (B) Salk and Sabin Polio vac (C) Sabin is alive attenuated vaccine (D) All of these a 68 ] Which of the following is a risk factor for the development of an ectopic pregnancy? | | (4) Prior Chamydial cervical infection (B) History of tubal ligation (C) Prior molar pregnancy (D) Prior miscarriage (E) Combined oral contraceptive pill use | Which of the following is the winged insect? | (A)Lice __(B) Sand (C)Flea___(D) Mite__(E) Tick 0 70 Tl Tn QRS complex: (A) I represent left ventricular depolarization (B) Physiological Q wave is more than .02 sec in duration (C) Itis less than 25% of R wave magnitude (D) The R wave is major negative deflection |B) The R wave is major positive deflection Regarding nuclear changes in cell injury include: (A) Karyolysis (B) Enocytosis (C) Pinocytosis (D) Autophagic vacuoles (E) Residual bod} ‘An adult young patient comes to your olinic with generalized pain, ache and skin rashes on body, | what is your most likely diagnosis : (A)Majaria __(B) Dengue fever__(C) Drug reaction _(D) Scarlet fever 7 7B 74 Regarding 22 years old lady primigravida in the first trimester, has blood sugar levels 300 mg/dl. | The most appropriate therapy to control her blood sugar: (A) Acarbose (B) Biguanides (C) Insulin (D) Insulin and sulphonylurea (E) Sulphonyl ureas Which of the following is the most common & widely distributed air pollutant? (A) Sulphur dioxide (B) Lead (C) Hydrogen sulphide (D) Carbon dioxide (E) Carbon monoxide_| ‘You have just examined a 28-year old primigravida in spontaneous labour, Examination findings are 0/5 palpable per abdomen, cervix is 7 cm dilated, cephalic presentation, -1 station, anterior fontanelle palpable with orbital ridges and nasal bridge felt anteriorly. What is the presenting diameter of the fetus? (A) Mentovertical (B) Occipitofrontal (C) Submentobregmatic (D) Suboccipitobregmatic (E) Suboccipitofrontal 76 Florescent microscopy is used for the following purpose except: (A) Glomerular disease (B) Tumors of uncertain Origin (C) Bullous dermatosis (D) Serum auto antibodies - _| In treatment of ulcerative colitis UC: (A) For induction of remission corticosteroid are considered first time agent (B) 5-ASA, Sulphasalazine are required for indication (C) Combination of oral and rectal enema of 5 ASA is better (D) In extension disease 5. ASA of corticosteroids are required (E) In limited disease oral corticosteroid are used 77 "The extra intestinal manifestation of Crohn’s disease (CD) : (A) Apthous ulcer 30% (B) Erythema Nodosum 20% (C) Pyodernia gangreosum 1% (D) Eye complications 10% (E) Acute arthriti 8 | Regarding the patient, who underwent surgery, suddenly developed acute shortness of breath. | The underlying cause is: (A) Heart failure (B) Pneumonia (C) Fat embolisin (D) Pulmonary embolism (E) Paradoxical embolism : 79 Regarding death during food poisoning, the causative agent is: (A) Bacteroides (B) Clostridium botulinum (C) Staphylococci (D) Shigella (E) Vibrio cholera 80 ‘Regarding the antiemetics function as a cholinergic muscarinic antagonist: (A) Aprepitant (B) Domeperidone (C) Hyoscine (D) Metocolppromide (E) Ondansetron 81 Side-effect of acute altitude hypoxia (or of the compensatory changes it leads to) include: (A) Decreased pulmonary vascular resistance (B) Decreased blood viscosity (C) Hypocapnic cerebral vasoconstriction (D) Increased bicarbonate reabsorptio (E) Decreased heart rate 95 of 06 kidneys@ “Tumour secreting placental alkaline phosphatase is? - (A) Carcinoid tumour (B) Archenoblastoma (C) Granulosa cell tumour (D) Dysgerminoma 83 Which of the following are features of tabes dorsalis? (A)Hypertonia _(B) Analgesia over the nose (©) Ataxia in the presence of impaired proprioception (D) Decreased gamma globulin concentration in the CSF (E) Colour blindness cs ‘Which one of the following is true about Acute Myloid Leukemia (A) Never caused by chemothraphy (8) Not associated with DIC Sean (C) More than 20% blasts for diagnosis _(D) Most common in children Inthe P wave: (A) It represent activation of Rt atrium | (B)P wave is upright in lead AVR (C) Normal P wave is 3 m.m is height (D) Normal P wave is 2.5 m.m in width (E) It is biphasic normally 86 Regarding the normal ketone body level in human is as under: (A)15—2 mgd] (B) 18-3 mg/dl (C) 1.93.5 mg/dl (D) 2.53.8 mg/dl 87 In management of acute infectious diarrhea: (A) Anti motility drug loperamide is indicated in children (B)E. Coli (ETEC) does not require antibiotics (C) 5HT3 receptor antagonist reduces diarrhea in children (D) Oligofructose is not very effective in preventing relapse (E) Metronidazole in drug of choice in clostridium difficult infection. . 88 89 90 ‘Regarding rheumatic fever, the diagnostic is: (A) ASO titer (B) Serum urea (C) Serum creatinine (D)Throat swab culture (E) Urine routine assay Which of the following is not a mechanism to promote venous return and reduce blood pooling? (A) One way venous valves (B) Parasympathetic stimulation (C) Skeletal muscle pump (D) Thoraco-abdominal pump (E) Pumping of the heart Inspiratory centre is situated in: (A) Upper part of medulla oblongata (B) Nucleus ambiguous anteriorly {C) Reticular formation of lower pons (D) Dorsolateral part of reticular formation in upper Pons (E) Lower part of Pons 91 ‘Conjunctival follicles are seen in (A) Trachoma (B) Spring catarrh (C) Keratitis (D) Muco purulent conjunctivitis (E) Strepto coceal conjunctivitis 2 Risk of metastasis is high in cancer of: (A) Oropharynx (B) Nasopharynx (C) Buecal mucosa (D) Larynx (E) Hypopharynx 93 ‘Acute fatty liver of pregnancy: (A) It occurs in 2™ trimester (B) It can cause acute hepatic failure (C) Treatment is immediate delivery of fetus (D) The cause of fatty liver is pregnancy (E) The cause is unknown [94 Immunization against hepatitis B also protects against. which of the following infection? (A) Hepatitis A (B) Hepatitis C_(C) Hepatitis E (D) Hepatitis D__(E) None of these 95 Regarding snake bite, which of the following statement is not correct? (A) The effecis of hemolytic toxins are immediate (B) Neurotoxins may exert a delayed effect on the victim (C) The reaction tothe bite will be ess severe ifthe bite is at proximal part of an extremity (D) The type ofthe first aid given to the victim will decide the severity of | outcome (E) Anti snake venom (ASV) is a polyvalent preparation “The respiratory system undergoes immense changes in pregnancy in order to cope with demands of the developing fetus ond labour. Which of the following parameters does not change? (A) Arterial pH? (B) Functional residual capacity (C) PaO? (D) Tidal volume (B) Vital capacity oF Best high risk disease management protocol in gestational trophoblastic disease includes: (A) EP/EMA or TE/TP (B) EMA/CO therapy (C) Methotrexate only (D) Methotrexate and Actinomycin (E) Methotrexate, vincristine and eyelophosamide 98 ‘Afr gastrectomy which one of the following conditions may happen: (A) Alkelosis (B) Malabsorption (C) Streatrorrhea (D) Anemia (E) Protein losing diarrhea [99 ‘Regarding the drug of choice in Chalmydia trachomatis infection during pregnancy: (A) Metronidazole (B) Cephazolin (C) Amoxicillin (D) Tetra cycline (E) Clindamycin 100 Which hormone causes ejection of milk from a lactating mammary gland? (A) Oxytoxin (B) FSH (C) Growth hormone (D) LH (E) Prolactin _—_—Ss.0f 06